Cultural adaptation of diabetes self-management education for Marshallese residing in the United States: Lessons learned in curriculum development

Karen Hye cheon Kim Yeary, Nia Aitaoto, Karra Sparks, Mandy Ritok-Lakien, Jonell S. Hudson, Peter Goulden, Williamina Bing, Sheldon Riklon, Jelleson Rubon-Chutaro, Pearl Anna Mcelfish

Research output: Contribution to journalReview articlepeer-review

26 Scopus citations

Abstract

Background: Type 2 diabetes is a significant public health problem, with U.S. Pacific Islander communities bearing a disproportionate burden. The Marshallese are a Pacific Islander community that has significant inequities in diabetes, yet few evidence-based diabetes interventions have been developed to address this inequity. Objectives: We used a community-based participatory research (CBPR) approach to adapt an evidence-based diabetes self-management education (DSME) intervention for the Marshallese. Methods: Our team used the Cultural Adaptation Process Model, in addition to an iterative process consisting of formative data and previous literature review, and engagement with community and academic experts. Lessons Learned: Specific cultural considerations were identified in adapting DSME components, including the dichotomous versus gradient conceptualization of ideas, the importance of engaging the entire family, the use of nature analogies, and the role of spirituality. Conclusions: We identified key cultural considerations to incorporate into a diabetes self-management program for the Marshallese. The insights gained can inform others’ work with Pacific Islanders.

Original languageEnglish
Pages (from-to)253-261
Number of pages9
JournalProgress in Community Health Partnerships: Research, Education, and Action
Volume11
Issue number3
DOIs
StatePublished - 1 Sep 2017
Externally publishedYes

Keywords

  • Community-based participatory research
  • Communityengaged research
  • Diabetes
  • Health disparities
  • Health equity
  • Marshallese
  • Minority health
  • Pacific Islanders

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